■同种异体干细胞移植(allo-SCT)和供体淋巴细胞输注(DLI)可能在小儿肉瘤患者中诱导移植物抗肿瘤作用。这里,我们描述了一般的可行性,allo-SCT后DLI的毒性和疗效。
■8例患者中有4例反应。在联合热疗/化疗的DLI和RMS#4部分反应8个月后,ES#4具有稳定的疾病(SD)9个月。在ES#4中,DLI导致SD持续6个月,并在allo-SCT完全缓解之前恢复残留疾病。DLI之后,ES#4和RMS#4发展为急性GvHD(°III-°IV),ES#4也发展为慢性GvHD。包括ES#4在内的5名患者的寿命比预期的更长。allo-SCT后的中位生存期为2.3年,复发后生存期(PRS)为13个月。Offnote,与HLA匹配的DLI相比,HLA不匹配的DLI与allo-SCT后生存率增加和PRS增加的趋势相关(23个月对3个月)。
■我们研究了8名接受DLI的患有晚期尤因肉瘤(ES#1-4)和横纹肌肉瘤(RMS#1-4)的青少年和年轻人(AYAs)。递增剂量范围为2.5×104至1×108CD3细胞/kg体重。评估了AYAs对DLI的反应,移植物抗宿主病(GvHD)和生存率。
■allo-SCT后的DLI可能以可控的毒性控制AYAs中的晚期小儿肉瘤。
UNASSIGNED: Allogeneic stem cell transplantation (allo-SCT) and donor lymphocyte infusions (DLI) may induce a graft-versus-tumor effect in pediatric sarcoma patients. Here, we describe general feasibility, toxicity and efficacy of DLI after allo-SCT.
UNASSIGNED: 4 of 8 patients responded. ES#4 had stable disease (SD) for 9 months after DLI and RMS#4 partial response for 8 months with combined hyperthermia/chemotherapy. In ES#4, DLI led to SD for 6 months and reverted residual disease before allo-SCT into complete remission. After DLI, ES#4 and RMS#4 developed acute GvHD (°III-°IV), ES#4 also developed chronic GvHD. 5 patients including ES#4 lived longer than expected. Median survival after allo-SCT was 2.3 years, post-relapse survival (PRS) was 13 months. Off note, HLA-mismatched DLI were associated with a trend towards increased survival after allo-SCT and increased PRS compared to HLA-matched DLI (23 versus 3 months).
UNASSIGNED: We studied eight adolescents and young adults (AYAs) with advanced Ewing sarcoma (ES#1-4) and rhabdomyosarcoma (RMS#1-4) who received DLI. Escalating doses ranged from 2.5 × 104 to 1 × 108 CD3+ cells/kg body weight. AYAs were evaluated for response to DLI, graft-versus-host disease (GvHD) and survival.
UNASSIGNED: DLI after allo-SCT may control advanced pediatric sarcoma in AYAs with controllable toxicity.